I just found out that I needed more than a yellow fever shot. I ended up getting yellow fever, tetanus, Hepatitus A, Hepatitus B and Typhoid vaccinations all in one big party today and now I am thinking about what to take for Malaria. A malaria map of Brazil reveals that Manaus, where I am going on the 24th, is in the middle of the big red blotch that says "High Risk". After talking to the vaccination nurse I realized that it is supposedly very stupid to spend a year there without taking something for malaria, but it turns out that this is not a yearly nor even a monthly thing. I would have to take a pill every day for the entire year, costing about $240 for the whole year, maybe cheaper in Brazil, and would have to wear sunscreen because a side effect involves being more susceptible to sun burns. Great! Now I'm supposed to wear long sleeve shirts and a hat, but I know that's not going to happen while I'm in a tropical paradise! There is a more expensive pill with less side effects for $160 for a months supply but unless it's super cheap in Brazil I won't be able to afford it. My question is, has anyone needed to take this stuff while living in Amazonas? Have foreigners gotten malaria in Brazil especially during long stays involving hardcore sport fishing? Is it absolutely suicidal to go without taking it, and if someone did take this stuff everyday for the whole year, how was all of that? I didn't realize this was a big deal but apparently it is, please someone give me some wisdom about malaria in Brazil and what to do about antimalarials.

Yeah, Manaus is in a high risk area for Malaria, more so in the city than in the jungle because of the amount of people there. But it definitely doesn't mean that everyone gets it. I knew someone who had been there for more than 10 years and had never gotten it. I don't want to say that you shouldn't take it, but it really is up to you. I was there for 4 months and chose not too take the pills...mainly because it's a pain and expensive. I used an insect repellent with DEET in the evenings. Also, tried to sleep with a sheet covering me and a fan on me to keep away the mosquitos. Seemed to work pretty well for me...some bites, but no malaria so far. I personally don't think I would take the pills if I went there again for a long period of time, but you need to make the decision for yourself.

What you said makes little sense. There is less malaria in the city than in the jungle. The city municipal workers spray a lot of toxic chemicals into the Manaus city area and that cuts down the malaria, and to top it off there are less mosquitoes in the city compared with the jungle.

Your chances of catching malaria in the city of Manaus are slim indeed.

I have lived in areas with malaria, and would not take it for long periods of time. Taking malaria pills for prolonged periods can be harmful to your liver.